Feline Seizures and Epilepsy

Written by: Bruce Lowekamp

The intent of this page
is to provide information for people whose cats have had seizures.
Seizures are a serious problem, and a cat that has had a seizure
should be taken to a veterinarian for proper diagnosis. A proper
diagnosis may be expensive and may take some time, but there is
usually an underlying cause that can be eliminated or appropriate
treatment that can be prescribed.

The information in this
page is not meant to substitute for a veterinarian's advice, but
to aid those who are trying to learn more about their cat's illness
and to encourage owners of cats that have had seizures to have
their cat's illness diagnosed as quickly as possible. More clinical
information is available through the references at the bottom
of this article.

What is Epilepsy?:

It is important to understand
the difference between epilepsy and seizures. Seizures, which
range from unusual mood swings to uncontrollable thrashing and
loss of body control, are symptoms of a disease. Causes of seizures
include infections, tumors, toxic chemicals, and epilepsy. Most
seizures in cats have a cause other than epilepsy. It's most useful
to think of epilepsy as a word for seizures for which no other
cause has been found.

You will sometimes see
epilepsy divided into idiopathic, or primary, epilepsy; and symptomatic,
or secondary, epilepsy. Idiopathic epilepsy is the term used for
seizures that appear to have no other cause. Symptomatic epilepsy
refers to seizures caused by an underlying condition.

Regardless of the terms
used, the primary goal when treating a cat with seizures is to
identify the disease causing the seizures, assuming it is epilepsy
only if no other cause can be found.

General Advice:

Seizures should not go
untreated. There are risks of choking during a seizure, and more
importantly, the seizures may be symptomatic of an underlying
disease that can and should be treated. Anti-convulsant drugs
may be effective in controlling the seizures, depending on the
exact diagnosis.

Observing Seizures:

If you observe your cat
having what you believe is a seizure, the most important thing
to do is to observe every detail you can about it so it can be
described to your vet. Frequently, your vet will never actually
be able to observe your cat having a seizure, so your description
is important to the diagnosis. Try to observe breathing patterns;
paddling, motion, or rigidness of limbs; eye dilation or motion;
salivation; body twisting; muscle twitching; and duration. It
is important to observe which parts of the body are involved.
After the seizure is over, your presence and attention will probably
comfort your cat as it regains consciousness.

Please note that there
is an incredibly wide range of symptoms associated with seizures.
Generalized convulsions are rare in cats. More common is the "partial
complex seizure," which involves an "altered consciousness"
and can involve anything from a lack of motion to bizarre behavior
such as attacking invisible objects or frantic running and collisions
with objects (yes, I know your cat does this normally, this is
why it's difficult to diagnose). The major indication that unusual
behavior is being caused by a seizure is the presence of "features
typical of seizure activity such as facial twitching, salivation,
or progression to generalized seizure." (Parent and Quesnel,
1996)

If a cat is having a
single prolonged seizure, continuous seizures without recovery
between them, or two or more isolated seizures within 24 hours,
seek medical attention immediately. Aggressive treatment is recommended,
usually intravenous dosage of diazepam.

Diagnosis:

Your close observation
and careful description will help your vet make a diagnosis. Specifically,
partial motor seizures are more indicative of symptomatic epilepsy
(suggesting an underlying disease), while idiopathic epilepsy
usually manifests itself in strictly generalized seizures. This
distinction is not conclusive; it is just one piece of evidence
to be considered.

A complete physical and
neurological examination should be performed on any cat with seizures.
Often blood tests are indicated to detect any generalized illness
that may be causing the seizures. These may include FeLV, toxoplasmosis,
FIV, FIP, urinalysis, complete blood cell count (CBC), and biochemical
profile. Based on these results, further tests may be indicated.
These may include analysis of spinal fluid to detect encephalitis
and imaging procedures, such as MRI or CT, to detect lesions such
as tumors.

You should be aware that
few vets have any experience with seizures in cats. They are rare,
compared with seizures in dogs. Ask your vet questions about what
tests they are considering and what your options are. A vet should
not be offended if you get a second opinion. This is important
to remember because I have received email from owners of several
cats that have died from conditions that could have been detected
with a simple blood test and treated quite easily, but were not.
If your vet cannot find any cause of the seizures and has not
done bloodwork, you should be concerned.

Treatment:

If a disease is found
to be causing the seizures, the best treatment is to remove or
correct the underlying problem. The success of such treatment
depends on your vet's ability to identify and treat the disease
or remove the growth that is causing the seizures. For example,
surgery is often effective for some tumors in cats.

If the diagnosis is epilepsy
or if the underlying disease is difficult to treat and/or not
becoming worse, then the usual therapy is to control the seizures
with anti-convulsant drugs. Phenobarbital is considered the initial
drug of choice for feline epilepsy. Diazepam (valium) may also
be effective but sometimes causes liver problems. The dosage must
be adjusted individually to minimize side-effects. Again, this
will require your careful observation; you will want to find the
lowest dosage that will control the seizures. Potassium Bromide
is also being used to treat epilepsy, particularly in cases where
liver problems or ineffectiveness may prevent phenobarbital from
being used to eliminate the seizures.

Some people have suggested
that a taurine deficiency may cause seizures. I have not yet seen
any information based on scientific research that would support
this belief. However, it is certainly true that a cat having seizures
should be fed a balanced diet that supplies adequate taurine.

The success of treating
your cat's seizures depends on the cause of the seizures and the
cat's response to medication. This is a difficult condition to
diagnose, so it may take several trips to the vet as different
diagnostic paths are pursued. Furthermore, your vet should not
be upset if you seek a second opinion. If it is difficult to find
the cause of your cat's seizures, your local vet may refer your
cat to a regional teaching hospital that may be able to pursue
a wider variety of tests and treatments and will generally be
cheaper.

What You Can Do:

Take your cat to
a veterinarian.

The most important step is to find a good veterinarian to take
care of your cat. If your cat has had one seizure, you should
call and make an appointment. If your cat has had more than one
seizure in 24 hours, find a vet IMMEDIATELY.

Learn about seizures and epilepsy.

This page and the links at the bottom are excellent places to
learn about feline epilepsy.

Make sure your cat gets quality care.

Ask your vet questions to see what tests are being done, what
problem they suspect and what future course of action they recommend.
Feline epilepsy is rare, so many vets are unfamiliar with it.
I have received email from people whose vets have not even done
blood tests on cats experiencing seizures and from people whose
vets have just said to monitor the behavior of a cat that was
having seizures more than once a week. In both cases, the seizures
were curable, but the vet was doing nothing to help the cat.
Bloodwork should always be done, and phenobarbital is generally
prescribed when no other problem is evident. If your vet seems
unaware of how to diagnose or treat seizures, find another vet
who can. Seizures, or the disease causing them, can be fatal
if not treated properly.

Decide what your limits are.

The decision of what lengths to go to is an issue between a pet
owner and veterinarians. After our vet was unable to diagnose
the cause of our cat's seizures, we were referred to a vet school.
The vet school didn't find anything in their initial tests, either,
so they asked us if we wanted to pursue an MRI or spinal fluid
test. Because of the high cost and smaller chance that a useful
diagnosis would be made from these tests, we elected not to pursue
either of these options at the time and began treatment with
phenobarbital. Since this has completely eliminated Shadow's
seizures for over five years, we have never had a reason to reconsider
these options.

Follow up on the care.

In some cases, your cat may be put on permanent medications.
For Shadow, this is phenobarbital twice per day. If you need
to give your cat regular medication, work it into your schedule
and consider how to handle extended absences. We take Shadow
with us on most of our trips.

Other References:

An article that focuses
on dogs, but contains a lot of good information about epilepsy
is Managing Epileptic
Dogs by William B Thomas, from the University of Tennessee.

As canine epilepsy
is a much more common and well-understood problem, there is a
great deal more information available about it on the web. Both
the Canine
Epilepsy FAQ and the Epil-K9
Canine Epilepsy Resource Center contain lots of very useful
information. Although the details concerning problems associated
with specific breeds are, of course, irrelevant, most of the
information provided there agrees with everything I've read and
been told concerning feline epilepsy (although idiopathic epilepsy
is much rarer in cats than dogs).

For other medical problems,
consult the Medical Information portion of the rec.pets.cats
FAQ.

Acknowledgements

Thanks to the people
who have provided information over the years as this page has
been developed. Special thanks to Joane Parent, from the University
of Guelph, who mailed me a copy of her paper "Seizures in
Cats."

Copying and Disclaimer

This article is Copyright
1996-1999, Bruce Lowekamp. Permission to copy, translate, or otherwise
redistribute this page is granted provided that this message remains;
the URL of the original, http://www.cs.cmu.edu/People/lowekamp/feline_epilepsy.html,
is retained as the source of the article; and the copy is not
made for profit or commercial use. Any commercial or for-profit
use requires written permission.

The author assumes no
liability for the result of actions taken based on information
presented in this article. This article is not an alternative
to the advice and care of a licensed professional veterinarian.
While some of the information presented here may offer suggestions
for choosing an appropriate veterinarian, the information is definitely
not a substitute for a licensed veterinarian. The information
presented here is to inform and comfort those people whose cat
has had seizures and have taken or are about to take their cat
to a veterinarian. If you think your cat is having a health problem,
consult a licensed veterinarian!